This editorial focuses on critical illness in the young in Jamaica and the likelihood of them getting the best healthcare. Posits that recognition and management are particularly challenging in infants and children, because of the age-specific differences in types of illness and range of physiologic values, the skill required to perform procedures on small children, and the unanticipated sudden deterioration especially in infants who have limited compensatory capacity. Argues that outcome of critical illness in children hinges on early recognition, expeditious anticipatory supportive intervention and prompt definitive treatment. However the disparity between available resources and burden of need suggests that many children in Jamaica will be denied access to optimized paediatric intensive care. The reality is that critically ill children are often managed on the ward where conditions and access to intensive care unit (ICU) is based on reactionary rather than anticipatory criteria.....read more